by Bob Roehr
The nearly 250,000 foreign-born children adopted into American families over the last 15 years are disproportionately likely to have gay or lesbian parents. A new study suggests that parents should not necessarily trust the foreign vaccination records of their children.
Dr. Emaculate Verla-Tebit and colleagues at the Case Western Reserve University School of Medicine in Cleveland reached that conclusion based on analysis of the vaccination records and blood antibody levels of five common early childhood vaccinations in 397 foreign-born adopted children. The study was published in the May 4 issue of the journal Archives of Pediatrics & Adolescent Medicine.
The children were examined within six months of their arrival in the U.S. They ranged in age from four months to 14 years, with a median age of 19 months. Most of the children had come from Russia (41.7 percent), China (20.9 percent) and Guatemala (15.7 percent).
The drawn blood was analyzed for protective levels of antibodies to polio, hepatitis B, tetanus, diphtheria, and measles.
The study found that protective levels of antibodies did not necessarily correlate with the paper records of vaccination. The rates varied by disease and country of origin. The authors concluded,
“These records, especially for children from orphanages, may not accurately reflect vaccine-induced protective immunity.”
There are a variety of possible explanations for these findings, including “documentation inaccuracies,” particularly for children housed in institutional settings (52 percent). Improper handling of the vaccine throughout the chain of custody from the manufacturer to administration of the shot can compromise its potency.
Stress and malnutrition can mute a child’s ability to develope a strong antibody response to the vaccine. The authors noted that a substantial portion of the children showed signs of acute (5.5 percent) and chronic (15.4 percent) malnutrition, such as stunted growth. So the child may have been vaccinated but because of poor nutrition may not have developed sufficient amounts of antibodies to provide protection.
An earlier study found that only 12 percent of children who lived in orphanages had protective immunity to diphtheria and tetanus compared with 78 percent of children who had lived in the local community.
Overall, records from Russia seemed to be a better indicator of protective vaccine status. Children from China were significantly more likely to have protective immunity against measles. The authors suspect this was from natural exposure to and recovery from measles rather than higher rates of vaccination.
“Primary care physicians dealing with this group of children should always consider measuring antibody titers to assess immune status rather than considering immunization records, even if those records appear to be valid and complete,” the study concluded.
One option for parents is to have a blood sample drawn and analyzed for antibody titers, and use that information to guide a vaccination strategy. Another option is simply to ignore the paper records and vaccinate their adopted children with the generally low-cost shots. That is what parents chose to do 5 to 21 percent of the time, depending on the vaccine.
Revaccination generally is safe. The most serious concern is an increased likelihood of a reaction at the injection site when DPT, a vaccine combining diphtheria, polio, tetanus, is administered.